{"reporting_entity_name": "Oscar Health", "reporting_entity_type": "Health Insurance Issuer", "plan_id": "11574IL001", "last_updated_on": "2025-12-23", "version": "1.0.0", "out_of_network": [{"name": "Radiologic examination, chest; single view", "billing_code_type": "CPT", "billing_code": "71045", "billing_code_type_version": "2022", "description": "RADIOLOGIC EXAM CHEST SINGLE VIEW", "allowed_amounts": [{"tin": {"type": "ein", "value": "330748075"}, "billing_class": "professional", "service_codes": ["23"], "payments": [{"allowed_amount": 12.2, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 34.0, "npi": [1407893894]}]}]}, {"tin": {"type": "ein", "value": "362169147"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 89.98, "providers": [{"billed_charge": 385.0, "npi": [1578670543]}, {"billed_charge": 445.0, "npi": [1164539730]}]}]}, {"tin": {"type": "ein", "value": "362174823"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 89.98, "providers": [{"billed_charge": 397.0, "npi": [1932213600]}]}]}, {"tin": {"type": "ein", "value": "362596381"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 89.98, "providers": [{"billed_charge": 728.0, "npi": [1265577191]}]}]}, {"tin": {"type": "ein", "value": "363097297"}, "billing_class": "professional", "service_codes": ["23"], "payments": [{"allowed_amount": 16.64, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 50.0, "npi": [1114695319]}]}]}, {"tin": {"type": "ein", "value": "363482203"}, "billing_class": "professional", "service_codes": ["21", "23"], "payments": [{"allowed_amount": 12.2, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 122.0, "npi": [1376755272, 1407807993]}]}, {"allowed_amount": 16.64, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 122.0, "npi": [1922264373]}]}]}, {"tin": {"type": "ein", "value": "370960170"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 89.98, "providers": [{"billed_charge": 768.0, "npi": [1497859649]}]}]}, {"tin": {"type": "ein", "value": "462494918"}, "billing_class": "professional", "service_codes": ["21", "23"], "payments": [{"allowed_amount": 12.2, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 38.0, "npi": [1376522177, 1255537858, 1669815015, 1043451081, 1063774735, 1053817049]}]}, {"allowed_amount": 16.64, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 38.0, "npi": [1588622682]}]}]}, {"tin": {"type": "ein", "value": "590910342"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 213.68, "providers": [{"billed_charge": 608.0, "npi": [1528042884]}]}]}, {"tin": {"type": "ein", "value": "911780160"}, "billing_class": "professional", "service_codes": ["21"], "payments": [{"allowed_amount": 12.2, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 29.0, "npi": [1881030260]}]}]}]}]}