{"reporting_entity_name": "First Choice Next, A Product of SHSC, Inc.","reporting_entity_type": "Exchange","last_updated_on": "2026-01-24","version": "1.0.0","out_of_network":[{"name":"Blood Count; Complete Cbc, Automated (Hgb, Hct, Rbc, Wbc, & Platelet) & Automated Differential Wbc","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85025","description":"Blood Count; Complete Cbc, Automated (Hgb, Hct, Rbc, Wbc, & Platelet) & Automated Differential Wbc","allowed_amounts":[{"tin":{"type":"ein","value":"991177652"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":9.63,"providers":[{"billed_charge":23.00,"npi":[1477749208]}]}]}]},{"name":"Collection, Venous Blood, Venipuncture","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36415","description":"Collection, Venous Blood, Venipuncture","allowed_amounts":[{"tin":{"type":"ein","value":"852276567"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":9.91,"providers":[{"billed_charge":25.00,"npi":[1760755003]}]}]}]},{"name":"Collection, Venous Blood, Venipuncture","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36415","description":"Collection, Venous Blood, Venipuncture","allowed_amounts":[{"tin":{"type":"ein","value":"991177652"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":11.27,"providers":[{"billed_charge":26.00,"npi":[1477749208]}]}]}]},{"name":"Computed tomography, abdomen and pelvis; with contrast material(s)","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"7417726","description":"Computed tomography, abdomen and pelvis; with contrast material(s)","allowed_amounts":[{"tin":{"type":"ein","value":"570963518"},"service_code":["21","23"],"billing_class":"professional","payments":[{"allowed_amount":89.10,"providers":[{"billed_charge":1671.00,"npi":[1003852039,1104808179]}]}]}]},{"name":"Emergency department visit for the evaluation and management of a patient, which requires a medically appropriate history and\/or examination and high level of medical decision","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99285","description":"Emergency department visit for the evaluation and management of a patient, which requires a medically appropriate history and\/or examination and high level of medical decision","allowed_amounts":[{"tin":{"type":"ein","value":"821910968"},"service_code":["23"],"billing_class":"professional","payments":[{"allowed_amount":153.42,"providers":[{"billed_charge":1870.00,"npi":[1477995470]}]},{"allowed_amount":187.61,"providers":[{"billed_charge":1870.00,"npi":[1184060931]}]}]}]},{"name":"Emergency department visit for the evaluation and management of a patient, which requires a medically appropriate history and\/or examination and moderate level of medical deci","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99284","description":"Emergency department visit for the evaluation and management of a patient, which requires a medically appropriate history and\/or examination and moderate level of medical deci","allowed_amounts":[{"tin":{"type":"ein","value":"650691102"},"service_code":["23"],"billing_class":"professional","payments":[{"allowed_amount":124.44,"providers":[{"billed_charge":1178.00,"npi":[1942206826]}]}]}]},{"name":"Emergency department visit for the evaluation and management of a patient, which requires a medically appropriate history and\/or examination and moderate level of medical deci","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99284","description":"Emergency department visit for the evaluation and management of a patient, which requires a medically appropriate history and\/or examination and moderate level of medical deci","allowed_amounts":[{"tin":{"type":"ein","value":"821910968"},"service_code":["23"],"billing_class":"professional","payments":[{"allowed_amount":105.78,"providers":[{"billed_charge":1280.00,"npi":[1932762564]}]},{"allowed_amount":109.95,"providers":[{"billed_charge":1280.00,"npi":[1740755081]}]}]}]},{"name":"Radiologic examination, chest; single view","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"7104526","description":"Radiologic examination, chest; single view","allowed_amounts":[{"tin":{"type":"ein","value":"570963518"},"service_code":["23"],"billing_class":"professional","payments":[{"allowed_amount":8.97,"providers":[{"billed_charge":248.00,"npi":[1699192088]}]}]}]}]}
